Objective:To evaluate the accuracy of endoscopic ultrasound ( EUS) in the preoperative TN staging for rectal cancer (RC). Methods:We searched CBM,CNKI,Wanfang and VIP databases from inception to Oct. 2013. Domestic articles related to the accuracy of EUS in the preoperative TN staging for RC were collected comprehensively. Related journals,conference proceedings,academic dissertations were also searched manually. Based on the principles and methods of Cochrane systematic reviews,data were searched,studied and extracted. Data analysis was conducted by Meta-Disc1.4 software. Results:Sixteen studies with 759 RC cases which met the inclusion criteria were included in this analysis. Pooling was conducted by both fixed and random effects models. Meta analysis showed that the accuracy of EUS in the preoperative T1-T4 staging for RC was high. Pooled sensitivity of EUS to diagnose T1-T4 staging were 87.0%,82.0%,87.0% and 76.0%,respectively. Pooled specificity of EUS to diagnose T1-T4 were 98.0%,93.0%,88.0% and 96.0%,respectively. The accuracy of EUS in the N staging was also high. To diagnose N staging,EUS had a pooled sensitivity of 76.0% and specificity of 81.0%. However,the accuracy of EUS in the preoperative T staging was superior than N staging. Conclusion:The results suggest that EUS combined with abdomen CT may be an effective tool for clinical preoperative diagnosis in TNM stage of RC,which plays an important role in clinical selection of surgical approach and treatment.